Provider Demographics
NPI:1629289780
Name:BURGA, DANTE ANIBAL (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DANTE
Middle Name:ANIBAL
Last Name:BURGA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4301 S FIGUEROA ST
Mailing Address - Street 2:# F
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-2660
Mailing Address - Country:US
Mailing Address - Phone:323-231-7700
Mailing Address - Fax:323-231-0799
Practice Address - Street 1:4301 S FIGUEROA ST
Practice Address - Street 2:# F
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90037-2660
Practice Address - Country:US
Practice Address - Phone:323-231-7700
Practice Address - Fax:323-231-0799
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA18132363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical